Clinical and bacteriological evaluation of nadifloxacin 1% cream versus erythromycin 4% gel in the treatment of mild-to-moderate facial acne vulgaris: A randomized study

Abstract

Objective: High percentage of Propionibacterium acnes resistance against erythromycin has been reported in recent years. Therefore, new antibiotic alternatives are being developed. Nadifloxacin is an effective treatment in mild-moderate acne vulgaris with antimicrobial, immunomodulatory and antiinflammatory properties. Comparison of the clinical and bacteriological efficacy and safety of nadifloxacin 1% cream versus erythromycin 4% gel in the treatment of mild to moderate acne vulgaris was aimed. Material and Methods: A total of 100 patients with facial mild-moderate acne vulgaris were randomized to receive nadifloxacin 1% cream (Group I) or erythromycin 4% gel (Group II) twice daily for 12 weeks. All the patients in both groups also used topical 0.05% tretinoin twice a week at night time for 12 weeks. Both groups were compared regarding the lesion counts and global acne grading score. The growth ratios of P. acnes and S. epidermidis were evaluated. The bacterial antibiotic resistance was assessed by using the minimum inhibitory concentration values of nadifloxacin and erythromycin. Results: After a 12-week treatment period, both treatments caused significant similar reductions in all types of acne lesions and the global acne grading scores. Microbiological evaluation revealed no significant differences regarding the growth ratios of P. acnes and S. epidermidis in both groups. The nadifloxacin resistant S. epidermidis colonization was significantly higher in Group I at week 12. Conclusion: Nadifloxacin 1% cream is as efficacious and safe as erythromycin 4% gel in the treatment of mild to moderate acne vulgaris.